Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | 0055 |
NPI | 1821353152 |
---|---|
Provider Name | Ms. Shawn Rice |
First Address | Beaumont, TX 77708-2908 |
Second Address | Beaumont, TX 77708-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 12/07/2012 |